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Twelve years ago I spent Christmas in a mental hospital. Just like Elsa in the movie Frozen, I lived the “Conceal, don’t feel” mantra with friends and extended family. I was terrified of being different, being labeled, being judged.

Four days ago I finished watching the Netflix series ‘13 Reasons Why’ and drafted an opinion piece which I published Monday morning. The show rocked me to my core. So much so, that I landed in the Emergency Room of my local hospital. This is the story of how and why that happened. I live with type 1 bipolar disorder. For those who aren’t aware of the various types of bipolar disorder, Bipolar Hope Magazine is an amazing resource and they have an informative section on their website which describes the types of bipolar and different symptoms. In a nutshell, my type of bipolar disorder means that I lean towards the manic side of the condition. If I’m not careful to protect my sleep, I could find myself launching into a manic episode. It doesn’t happen overnight, rather, over the course of several nights of getting little to no sleep.

As I mentioned in my opinion piece, I put my mental health at risk by choosing to watch the show. I didn’t know how risky it was to begin watching the show because I’ve been mentally healthy for the past 7 years. The last time I was hospitalized for a manic episode was, ironically, exactly seven years ago this month, when I was 5 weeks pregnant with my second child. I thought since I had been so stable for so long, it couldn’t possibly be that risky to watch a few episodes.

I was wrong.

I started watching the show Friday evening, and got through four episodes (binging) before forcing myself to shut it off so that I could get some sleep before flying to Cedar Rapids, Iowa for my nonprofit’s show the following night. Our Iowa Corridor This Is My Brave show was incredibly moving and inspiring, as all of our shows are, and I was so excited to get to spend time with the show’s producers and cast members afterwards. We went out to a local bar and played Cards Against Humanity while eating and hanging out. I had a blast. But unfortunately didn’t get to sleep until 2am EST, and awoke at 6am Sunday morning. I usually sleep well when I’m on the road, but I had so much on my mind having started watching the show the night before and wanting to continue watching.

I pushed play on episode 5 shortly after waking up, and was able to finish the series in the airport on my way home on Sunday. I was furious by the time I finished, and reached out to several of my friends via text to see if they had watched and to get their thoughts. Everyone seemed to have similar feelings, but slightly different reactions. Overall, the few people I was able to connect with directly were shook up by the show, but were glad it was out and was opening the eyes of the public.

At that point I began thinking about those in my circles who were already vulnerable, sensitive. How would they take it if they had watched? How would teenagers react to the show? Especially if they didn’t have solid support systems in place, if they were already in a tough place, if they didn’t have the energy or resources to access proper mental healthcare.

I landed around 8:30pm and grabbed an Uber home. I normally enjoy chatting with the driver, but on this particular ride I needed to connect with one of my close friends. I called my This Is My Brave Co-Founder Anne Marie Ames. She and I have been friends for four years, and I needed to tell her how the show affected me. We talked the entire ride home, and agreed to catch up again during the week.

My husband had let our kids stay up late so they could see me, so I hugged and kissed my little people and got them tucked in by 9pm. My husband knew how I was feeling because I had called him from the airport, and he knew that I wasn’t sleeping well. The plan at that point was to focus on sleep all week, make it a priority again. On the flight home from Chicago I had jotted down my feelings and initial reaction to '13 Reasons Why', and I told him I felt that if I was able to get them organized into a piece that made sense, I’d likely sleep better. I started pulling my thoughts together, tapping away at my laptop, and he went up to bed.

I crawled into bed around midnight, as it had taken me longer than I had hoped to draft my reaction. But I did feel better once I got it out, so I was hopeful I’d be able to get some quality sleep.

Only, instead of crashing and sleeping hard, my sleep was broken and riddled with nightmares. I woke at 5:30am, and since my husband was already downstairs doing his normal early morning workout in the basement, I grabbed and pen and paper and let my feelings flow again. I shot off a draft of my revised piece to two friends and by then it was time to wake the kids and get them off to school.

I recognized my symptoms of hypomania and immediately told my husband that I was going to call my psychiatrist at 8:30am when they opened to get an appointment. He said that he thought that was a good idea and off my family went to work and school. I normally find relief in the calm of the morning once the house is quiet and I’m on my own. But instead I found myself feeling that familiar current of mania beginning to rush through my blood and anxiety creeping in.

I still hoped I could relieve some of these symptoms by publishing my reaction to the show. I felt a little better after hitting Publish on Medium, but things escalated quickly from there.

I picked up my kids from school and took them out for frozen yogurt, one of our favorite treats. I hadn’t seen them all weekend, so it was fun to catch up. As we were sitting there, Kelly, my best friend from college called to see how our Cedar Rapids event had gone. I told her it was amazing, as all our events are, but that I had a lot on my mind. She caught on immediately that I wasn’t in a good place, probably based on the tone of my voice, but I told her I couldn’t talk because of where we were and the kids were with me. She offered to pick up the groceries I said I’d be running out for later that evening, so that I could head to bed early instead. She agreed to meet me back at my place in ½ hour.

{One of the things Kelly asked was critical for her to know how I was doing mentally, and she knows this from being there when my very first manic episode came on back in December of 2005. She asked me where I was on a 10-point scale. I was at a 6-7.}

When a person with type 1 bipolar is at a 6-7, it means that they’re in a hypo-manic state. A person can very quickly go from a 6-7 to a 9-10, meaning they need to be admitted to a psychiatric hospital, if things aren’t addressed in an urgent manner.

Once we were home, I did my best to summarize for Kel why the show '13 Reasons Why' affected me so deeply. She’s a teacher, and hadn’t heard of the show, but when I told her how I had met a friend of mine for coffee that afternoon, she had a better understanding. The friend I met up with had been directly impacted by suicide, as her son Jay took his life last year, and now the family is pursuing a lawsuit because Jay’s guidance counselor had been alerted by a friend three weeks before he took his own life. The counselor had neglected to contact Jay’s parents. You can read about it in the Washington Post.

Little did I know, Kelly had already set an emergency intervention plan into place, even though she may not have noticed it at the time. While she was picking up the groceries for me, she called my husband and let him know that she was concerned about me. She also texted another one of our close friends from college who had a friend who was a pharmacist. (What can I say? It takes a village.)

When Ben got home, he found the kids happily playing video games, while Kelly and I were sitting in the dining room trying to figure out a plan. I needed Ambien to ensure that I got a solid night’s sleep. The only problem was that I hadn’t used a sleep medication in seven years, so we didn’t have anything (expired or otherwise) in the house. We called my psychiatrist’s office to see if we could get through to an after-hours line. We left a message for my doctor’s medical assistant, but by then it was already 6pm and we were running out of time. We called my regular pharmacy, but my psychiatric medication info was out of date. (Side note: I use a mail-order pharmacy to fulfill my regular mood stabilizer prescription which I’ve been on for the past 7 years at the same dose.) The pharmacist at my regular pharmacy recommended an over-the-counter sleep aid, but we weren’t convinced that would work for me given my level of hypomania.

Our friend who is the pharmacist (in California) communicated by text that if I didn’t have Ambien on hand at home, I would need to go to the Emergency Room to get a prescription for it, and that was what she recommended given my symptoms. I argued it was overreacting, but based on my experience living with this condition for eleven years now, and my past 4 psychiatric hospitalizations for mania, I also knew she was right.

Kelly offered to drive me to the hospital while Ben held down the fort at home. I resisted at first, as it seemed dramatic and unnecessary. I wanted to just get an OTC sleep med, and said we could get Ambien the next day from my psychiatrist. But looking back now, it's a good thing I didn't resist as I could have ended up in handcuffs again, being carted off to the Emergency Room and then the psychiatric hospital. I didn't want my kids to have to see that happen, so I happily went along with the intervention plan.

We joked on the drive over about how efficient my intervention team was and how I was voting her President of the team based on her stellar performance. (In college, Kelly was President of the water polo team and I was Vice President, so it seemed fitting.) We were immediately admitted to the ER, the intake nurse took my vitals, and I was sent back to a triage room with a bed. By that point I had called my parents to let them know what was going on, letting them know the plan and that we had everything under control. They were worried but relieved, and asked that I keep them posted.

The ER doc was really great, and got us in and out quickly with a script for the Ambien that hopefully would do the trick and get me through until I saw my psychiatrist on Wednesday. Ben had called his mom and she was already at our house by the time I was getting my discharge papers, and he met us at the hospital right as I was released so that he could drive me to get my script and Kelly could head home to her family.

Ben’s mom got the kids in bed as I called my parents to update them once we got home around 8:30pm. I ate a little something for dinner, and was crawling into bed by 9:30, ready to let the meds do their trick and lull me into a deep sleep.

Only it didn’t exactly work as planned.

I slept from 10pm until I woke at 1:30am, unable to get back to sleep. Hypomania/mania has a way of doing that to a person. I woke my husband and told him I couldn’t sleep, so I took another dose of the sleep med. I woke groggy at 6am Tuesday morning. Concerned that I had to take two doses, when in the past one dose had worked for me, we called to bump up my psychiatrist appointment, and luckily she had a slot in her schedule for Tuesday afternoon.

My husband was able to take time off from work to drive me to my psychiatrist appointment. We filled her in on everything that had happened, and made a new plan including medication changes. She provided us with her emergency contact info in case we needed it, and answered all our questions. We were in and out in an hour total. My mother-in-law was able to help us with our kids while my husband went back to work for the afternoon and I went to run a few necessary errands, including picking up my new prescription. My therapist (who I haven’t seen since December, because I’ve been “busy”), has an awesome online scheduling tool for current clients. I grabbed one of her only two open appointment slots for Thursday.

Tuesday night we followed the plan. It was extremely difficult to get out of bed Wednesday morning due to the side effects of the medication changes. I haven’t had trouble getting out of bed because of my mental illness for so many years that I forgot what it felt like. It’s hell.

My anxiety has returned due to this “almost-episode,” which is totally normal. It’s just been so long since I’ve felt it that it’s been a little overwhelming. Uncomfortable, yes. Manageable, yes. Especially when I have such an incredible support system and so many resources at my fingertips.

I may have been able to stay mentally healthy for seven years, and yes, that's a long streak. But if this week has taught me anything it's that I'm not immune to relapses. I live with type 1 bipolar disorder and I'll always have it. Like any other chronic condition, it's lifelong. I'll continue to kick bipolar's ass, I know I will. I'm even a little grateful for this week's experience because I had been feeling like a bit of an imposter lately, having not felt symptoms for so long and getting to do this nonprofit work where I hear stories of individuals overcoming mental illness every week. I'll forever be a member of the club, my tribe, as I call it. And together we're ending the stigma surrounding mental health disorders. One true story at a time.

*****

About a year ago, I wrote a guest post for a website called OC87Recovery Diaries, and in it, I stated that we didn’t have a plan. The reason I’m publishing this post is not to highlight how fortunate I am, but to point out how I almost landed in a psychiatric hospital this week, but didn’t, because we had a plan. It may not have been a formal, executed WRAP (Wellness Recovery Action Plan), but it was darn near close, and it worked.

If you or someone you love lives with a mental illness, it's important to have a plan. And if you're in a tough place right now - here are some things I find helpful:

Know your local and national mental health resources, including the crisis hotlines. This Is My Brave's Resources page is a great place to look, or even just Google it and keep that info handy.

Make sure you know how to contact your psychiatrist after-hours in case of emergency.

Keep a journal that lists the meds you're currently taking and what's working for you. Allow those closest to you to have access to this in case of emergency.

Don't be afraid to be completely honest about how you're feeling. Feeling overwhelmed, triggered, fragile, etc., and sharing your feelings with those you trust is NOT weakness. In fact, it's the complete opposite. It's brave to allow yourself to be that vulnerable and it leads to deeper, more close-knit relationships with the people you love.

Don't lose sight of self-care. We often get so wrapped up in our day-to-day lives that we forget to take time out for ourselves, and being too "busy" can lead to burn-out and mental health issues.

I received what most people would consider to be an odd phone call last week. It left me thinking about what it would be like to live on a farm in Canada. Let me explain...
I was driving to meet my grad student volunteer in DC to finish up a project, when my phone rang. It was a man named Stephen who lives on a farm outside of the capital city of Canada, Ottawa. He mentioned that he found me online googling bipolar, as we both have the same condition, and that he thought maybe I might be able to help him find a family or group of people who might be interested in taking over his farm.

I found the request pretty insane, and Stephen admitted it was a little "out there," but you never know with the internet. When we put things out via our networks, you never know how far it will go and how you might be able to find a needle in a haystack. So I asked him to send me more info via email, and later that evening, he did.

Here's his note:

Hello Jennifer,

It was nice to connect with you by telephone earlier today with my rather unusual (insane?) idea of turning over my farm.

I clicked onto your site because I am bi-polar among other things. I'm 62 and as of two years ago freshly divorced type of situation. Messy for sure and a catalyst for soul searching avenues. What I felt made a difference is the setting I put myself in. I bought a historic farm with a water view to boot, and filled it with an insane number of farm and domestic animals. I'm sure you've read how some people find being surrounded by animals to be therapeutic. In this vein I thought on a long shot there may be a couple or group of people who wanted to change their life settings. I'd like to say change their life but you and I know better and that "wherever you go there you are" type of outlook. But for sure, being in a different atmosphere, if it is a fit, can be beneficial to one's health.

My fifty tiled acre farm is located in a small town, about fifty minutes away from my nation's capital, Ottawa. Yes, I am in Canada but perhaps there are followers of your blog that right now would welcome a move outside of the domain of that new guy in Washington!

My idea is to find someone who is not dirt poor and perhaps has a home-based business which does not restrict them to living elsewhere. I would basically allow them to live here forever without paying rent in exchange for taking care of some of my animals, a deal that would have to be customized between us. I have a car, but no tractor, four barns, a paved driveway and a wonderful stone home built in 1830 with over 3,500 square feet, perfect for a family, inviting for someone who wants to set up some sort of new business as well. My land is currently rented out to an organic farmer but could be used by the new person(s).

So basically, in exchange for taking care of what is in reality my vast pet kingdom you get to run the farm without any charge. You have to pay for the running costs and taxes of course which are not daunting mind you but it still requires an outlay. I bought this property outright and do not have it mortgaged.

I am a two minute drive to every type of store you might need for food, etc. beside a small town.

Bi-polar is not something one "cures" but as you might agree life can be beautiful if you surround yourself in an appropriate way to keep on healing and in this light I think my farm setting might be of use. I plan to go back to Japan where I was living before coming back to Canada a few years ago.

Not sure what else to add here but feel free to ask any questions.

Stephen

I've spoken with Stephen, and he'd be interested in speaking with anyone who'd like to talk with him about this opportunity. So if you've ever dreamt of living on a farm, and you'd like to move to Canada, please email my friend Stephen at wonderfulpens@gmail.com.

Today is the third annual #WorldBipolarDay. This day is important to me because it is helping to open up and continue the conversation surrounding a mental illness that is misunderstood in our society - bipolar disorder.
I was diagnosed over ten years ago. My world was turned upside down when I suffered two manic episodes in one month, each requiring hospitalizations. Soon thereafter, I received the diagnosis of bipolar disorder and spiraled into a severe year-long battle with depression and anxiety. I felt utterly alone, scared to talk to anyone about it outside my immediate family. My illness told me I was broken, worthless, and that I'd never get better. I believed it for over a year.

But it was lying.

I eventually found the right medication, and I did get better.

But then I got sick again when I was trying to protect my kids. I thought as their mom I knew better. I should have listened to the doctors.

Hindsight is 20/20 though, I had to learn the hard way. I don't regret my decisions. They brought me to where I am right now.

I'm no one special. I'm just a person who was handed a diagnosis, went through a fierce struggle, learned to accept it, and wasn't willing to allow society to intimidate me, judge me, and discriminate upon me for something that wasn't my fault.

I am playing the cards I was dealt, as my favorite author, Cheryl Strayed, has so wisely stated.

You don't have a right to the cards you think you should have been dealt. You have an obligation to play the hell out of the ones you're holding. - Cheryl Strayed

I share my story because I know there are people out there searching for stories of resilience right now. I know because ten years ago, I was one of them. If my story can help just one person understand that they can overcome bipolar disorder, than I've accomplished what I've set out to do.

When I received an email recently with an invitation from Mental Health America to attend a free screening of Touched With Fire a new film about bipolar disorder starring Katie Holmes and Luke Kirby, I RSVP'd immediately. It fascinates me to view my illness through the eyes of another person touched by this diagnosis. And this film was written, music composed and was directed by a man who lives with bipolar illness.

Filmmaker Paul Dalio was diagnosed with bipolar disorder at the age of 24, and like me, struggled to accept the label. He said he romanticized the mania, pointing to famous poets and writers who shared the condition. He's developed a strong sense of pride and I could wholeheartedly relate. It seems his experience over the years has led him to a place I find myself in now: able to live in harmony with bipolar, with a loving family and a full life.

Several of my volunteers and one of our new This Is My Brave interns joined me at the screening. We all were impressed by the film, it's ability to express the artistic side of the disease, how family members struggle with how to help or walk away, and what happens when one refuses to comply with medications and treatment.

Plus, it's a love story. That was probably my favorite part about the movie. And it has a great ending.

I did have a concern as I reflected back on the scenes and the dialogue though. So many moments brought me back to my initial diagnosis and the years that followed.

Like when my parents kept referring to what was happening to me as "episodes" which made me feel so broken.

And when I questioned whether I even had bipolar disorder. I didn't think I needed the meds.

And the times I went off my meds (to protect my unborn babies) only to end up manic and hospitalized within a week both times.

I worry that the film will be dangerous to those who are not in a solid place of recovery. It's been ten years since I've been diagnosed. Coming up on six years since I've had a manic episode requiring hospitalization. I'm at a place where I know that I will never go off my meds. I know what my triggers are and I know how to manage them. I take such better care of my body and my mind compared to where I was back when I was still learning to understand my condition.

Someone who is early in their recovery journey may be tempted by the film to get rid of meds, to go back to life before being medicated because they were so much more artistic (not true). Paul, the filmmaker, even commented on the fact that he's so much more able to utilize his creativity to attain his goals and dreams being on medication and stable. Something that Dr. Kay Jamison taught him when they met and she became a mentor to him, a connection made possible by his own psychiatrist.

Speaking of Dr. Jamison, she makes a cameo in the movie and I got to say hello to her after the screening and Q & A. I told her how much I admired her work and how I attended one of her book signings in 2007 and asked her about pregnancy and medication. Her advice to me was to stay on my meds, which I did not heed and learned my lesson the hard way. She was very glad to know of the work This Is My Brave is doing and I'm hopeful she'll be able to attend a local show in the near future.

You never know how someone will respond when you put your story out there, when you put your art out into the world. Paul has taken a risk that was no doubt worth taking. My hope is that the film will not live up to my concerns, but instead serve as a springboard for important conversations surrounding mental illness and mental health that need to be taking place in communities everywhere.

The film opens tomorrow, February 12th in New York City and Los Angeles, and on February 19th nationwide in select cities. You can watch a trailer of the film HERE. This Is My Brave is hosting a Meetup for anyone in the DC-metro area who would like to come together to support the film's opening weekend. Click here to sign up to meet us on Friday at the Angelika Film Center in Fairfax for the 7pm-ish showing.

Nine years have passed since my life was shattered by depression and anxiety. Tonight, as I sit here typing on my laptop, it's hard to imagine how someone could be suffering so deeply that suicide could seem like the best solution. But nine years ago, I felt the pull to end my life. The pain was too heavy, I couldn't see a future. My world was a mix of meds, doctor’s appointments and therapy appointments. Repeat, repeat, repeat. Just trying to get out of bed in the morning was a monumental feat each day. I couldn’t see hope. I was blinded by my depression. I thought maybe it would be easier to just stop living.

Fortunately I didn’t sit with those thoughts alone for too long. I was completely ashamed of having those feelings, but something inside me begged my heart to tell my husband and my parents. And so I did. They fought like hell to get me back from the ledge. I do know how lucky i am to have the support system which surrounds me.

It was during that time my dad suggested I take a part-time administrative job to pass the time and give me something to do while I worked on getting well. I was hired by an overly-confident, condescending VP to manage his calendar and other secretary work. His management style exacerbated my anxiety. I dreaded going to work three days a week, although I made several friends in the office who made it tolerable, so I stayed.

Bertie was my angel when I was there. A soft-spoken, slim African-American woman in her fifties, I’d take breaks just to walk by her reception desk and chat. She’d invite me to pray with her, the worn bible always in her purse, pages marked. I know she could sense my unease. Sitting beside her with my hands folded in my lap and her gentle voice reciting psalms and prayers, my breath steadied. I felt loved and noticed.

This week I learned of two suicides in our local area: one a young, prominent veterinarian, the other a 19-year old girl with a beautiful smile. News circulated today about a mother suffering from postpartum depression and anxiety who took her baby’s life and then her own a few weeks ago. Then the Lafayette shooting in the movie theater where it’s been reported the gunman had serious mental health issues. And of course the Sandra Bland story. So much sadness. So much lost.

My heart breaks for the families and friends of these victims of mental illness. We have so much work to do.

You may not be one of the 25% of Americans who live with a diagnosed mental illness. But chances are extremely high that someone in your life, someone you love, does live with a mental health disorder.

So what would happen if we would pay closer attention to the people around us? Be open to noticing when a friend is struggling and extend a supportive listening ear and a hug. Or help that person into counseling if you suspect they’re not taking care of themselves the way they should be.

In our day-to-day activities, even simply looking people in the eye and smiling can make a huge difference in someone’s day. You might be the only person who noticed them. We’re so attached to our devices that we barely look up anymore and connect with the people in front of us. I’m totally guilty of it too, but we can change.

I know it seems unfathomable to think that someone would choose to end their own life. But when your entire world collapses on top of you, and you cannot muster the strength to pry it off to start over, giving up feels like an easy way out. Let’s connect as a society so that people realize their lives are worth living. Don't underestimate the power of extending a hand to someone in need.

I've been writing in journals ever since I was a tween. Back then they were sparkly little diaries with the lock and key protecting all the secrets inside. I'd write about life and love, about boys I thought I'd fallen in love with but who didn't actually love me back. Or about arguments with my parents or my friends, trying to justify my side of the story.

I turned to journaling whenever the moment struck me, throughout high school and college, and even once I had graduated and started out on my own in the world. My husband and I traveled Europe for a week together after I completed a 2-week study abroad in Antwerp, Belgium, and I still love flipping back through that play-by-play notebook of our trip. I can almost transport myself back by reading those words.

I never realized how many ways the simple habit of putting pen to paper could actually help someone until it helped me.

When mania threatened to ruin my life with two psych hospitalizations in a month's time, everyone close to me was sent spinning. Psychiatrists, therapists, prescriptions. It was all so new to us.

My husband may have been scared, but he wasn't afraid to stand by my side through the hurricane of what was now our life. My parents, although heartbroken for the pain and uncertainty I was facing, were committed to helping me get well.

In the midst of doctor's visits and the flurry of medications I was put on, I felt out of control. Too much was going on. There were all these symptoms and I didn't know how to describe them. I couldn't pronounce the meds I was on. My mind felt weird.

A week after my second hospitalization, my dad came up with a brilliant idea. He bought me a plain pocket notebook at CVS, and told me to write down the same three things each day: what meds/doses I took each day, any side effects I was experiencing, and how I was feeling. That way, we could work with my doctor to figure out what was going on in my brain and how to get me well.

I kept those journals for four years straight, barely ever missing a day. Some days I'd only write those things my dad said to write, other days I'd write pages and pages. I used it to track my progress. It helped me to recognize my triggers. I learned a great deal about myself through taking the time to put my thoughts down on paper.

It was the start of my writing my way through my mental illness. Which has led me to where I am today. I haven't kept a journal since 2010, since that's when I starting to transition my words online to this blog. But I want to return to it because I recognize how I love looking back at the past, to see how it led to the present.

Being diagnosed with a mental illness can be absolutely terrifying in the beginning. But getting through it doesn't have to feel impossible. It takes time to get to the bottom of things, to figure out what meds work, to start feeling like your old self again once you do find one that works. Trust me, I know.

Also trust the process.

I saw these little journals in a drugstore this week. They reminded me so much of the small Vera Bradley notebooks I transitioned to after I filled up the one my dad bought for me. I bought two, one for me, and one to give away to one of my readers who could use it.

My blog turns four years old this August. Having come to this little corner of the internet for nearly four years, writing my story of how I've navigated pregnancy and beyond despite living with the diagnosis of Bipolar disorder type 1, I tend to get quite a few questions from my readers. The most common ones come from young women who like me, wondered how they would be able to manage their illness and still be able to care for a newborn. A newborn who would grow into a baby with many demands.

I certainly am not perfect, nor am I an obstetrician or psychiatrist. I'm just a regular mom who, after having found out she had bipolar disorder, wasn't going to let it get in the way of her dreams of having a family. These are my reflections, looking back on my experiences of having my two children (now 6 and 4). This is what happened to me, and how I'd do things differently if I were to have a third child. (We are 99% sure we won't be having another one, in case you're wondering.)

Accepting the diagnosis

Bipolar disorder is a challenging, life-long illness. The first year or two of learning to live with the diagnosis can be devastating and all-consuming. When I was first diagnosed, ten years ago at the age of 26, I had to resign from a career that I excelled at in order to focus on getting well. It took an entire year for me to work with my doctors and therapist to find a medicine and figure out a treatment plan that worked for me. I was able to overcome severe depression and crippling anxiety, and even suicidal thoughts thanks to the vigilance and support of my husband and parents. Once I found stability, and was able to maintain it for a year, my thoughts of starting our family began to take root.

Although I was able to taper off my medicine (under the close supervision of my psychiatrist), and I had a normal, healthy pregnancy, we were not prepared for what would happen next. Not only was having our first child an incredible shock to my system (I had an emergency C-section after 17 hours of laboring - no pushing, but since the baby wasn't tolerating contractions and I wasn't dilating, my OB made the call for surgery), but nothing can prepare you for how you'll react to motherhood. On top of all this, I had put an enormous amount of pressure on myself to breastfeed. I thought, from all the pregnancy literature I had been devouring before the baby arrived, that breastfeeding was the only acceptable means of feeding the baby.

I was wrong and I learned the hard way.

Even though I knew that lack of sleep was a trigger for me, I didn't realize how little I'd be sleeping once the baby arrived, especially due to trying to nurse. I barely slept at all in the hospital since the nurses checked my vitals every hour because of the surgery. Exhausted doesn't even begin to describe how I felt. But I couldn't take my eyes off our son. We had created a baby. I was in awe of this little person I was holding. It didn't seem real. Maybe partly because I was headed into the throws of mania even before we left the hospital.

1. Have a plan for once you get the baby home

With our first baby, I did everything and wouldn't let anyone help. I was trying to succeed at breastfeeding and if someone gave the baby a bottle, he might not go back to nursing. Which meant that I was always the one getting up in the middle of the night to feed and change the baby.

With our second, we had a plan. For the first two weeks, someone would be available to take the middle-of-the-night feedings. My parents stayed with us for a week, so they took turns during the first week home, and then my husband took over during weeks two to four. This allowed me to get a solid stretch of 6-8 hours of sleep a night, critical to my recovery from the birth (a repeat c-section) and to prevent mania from creeping in. I learned to protect my sleep, and because of this, was able to stay mentally healthy once we brought our daughter home.

2. Don't feel guilty for formula-feeding

I breastfeed our son for the first four weeks of his life, and then ended up in the psych ward for a week because of postpartum psychosis. Having to stop breastfeeding was devastating, but on the way home from the psychiatric ward of the hospital I realized that being healthy for him was more important than anything. If I didn't have my health, I wouldn't be able to be present as a mother, no matter how I wanted to feed him.

For our daughter's arrival, we planned ahead of time that I would not breastfeed. Instead, I got excited about picking out bottles and supplies to formula-feed her, and my postpartum time with her was so much more enjoyable since I didn't have the extra pressure to make nursing work. I ended up having antenatal psychosis (mania during pregnancy) during the first trimester of my second pregnancy, so I had to take antipsychotics and a mood stabilizer during the pregnancy. Nursing was never an option and I accepted this reality.

3. When a medication works for your condition, weighing the benefits and risks is critical

Having experienced postpartum psychosis after the birth of my first child, we were better prepared, or so we thought, to navigate a second pregnancy successfully. We knew that I needed to protect my sleep, and I planned from the moment we decided we wanted to have another baby that I would formula-feed since I'd be returning to my medicine after the first trimester. Going off my medicine for the first trimester was my mistake.

From my research, I knew there was a risk to the fetus of a heart defect during the first trimester of pregnancy when women took the medication I was taking during pregnancy. So I made a plan with my psychiatrist and the high-risk OB-GYN that I'd taper off the medicine when I found out I was pregnant, and I'd return to it once I cleared the first trimester. Only I hadn't weighed the benefits of staying on the med against the risk I was taking.

I was closely monitoring things, testing for pregnancy on the earliest day possible following my fertile period. When I finally got a positive test, my excitement over finally being pregnant (we tried for about nine months) took ahold of my body and would not let go. My mind raced with potential baby names as I'd lie awake in bed not able to fall asleep.

Would it be a girl? How would our toddler react when he met his new sibling? What would it be like to be a Mommy to two little ones?

Within a week of very little sleep I was manic and it was quickly leading to psychosis. Having witnessed my manic symptoms before, my husband quickly took action and had me hospitalized. I was five weeks pregnant with our daughter.

When I returned home, medication was required to keep me stable. I went back to the high-risk OB-GYN for a post-hospitalization check-up and was scheduled for regular checkups and monitoring of the baby throughout the pregnancy. Luckily, she was born completely healthy and I had a wonderful postpartum period with no complications. I learned that my risk for psychosis due to the lack of medication in my system was far greater than the risk to my baby in utero.

*****

If you're considering pregnancy or are currently pregnant, I urge you to work closely with your psychiatrist and OB-GYN to monitor and manage your bipolar symptoms during pregnancy and in the postpartum period. There are great resources available online to help you as you navigate pregnancy: Postpartum Progress, Postpartum Support International, and if you're in the Washington, DC metro area (Virginia, Maryland and the District), the newly developed DMV-PMH Resource Guide maintains a comprehensive and current regional directory of specialized mental health providers, support groups, advocacy organizations, and other relevant clinical resources pertaining to perinatal mental health.

There are resources available. Please don't hesitate to ask for help. You can be a mom despite bipolar.

I’ve always been the type of person who wanted to make the invisible visible. It’s just in my nature. Engrained in my being. A part of who I am. I am someone who wants to share where I’ve been so that others can learn and grow, the same way I desperately want to hear what others have gleaned from their life experiences. I crave this deep, intimate knowledge of people. When I open up to someone and they lean in and open up in response, I know I’ve found my people. Small talk makes my skin crawl.

When I meet someone for the first time though, small talk is inevitable. At first glance, no one would ever guess that I’ve been diagnosed with a mental illness. Likewise, I’d never know if the person in front of me had ever been so depressed they couldn’t get out of bed in the morning. So many of us live with these potentially, and often times, debilitating illnesses in our brains, and yet we present as perfectly capable, fully-functioning, regular old citizens going about our daily activities. Waking up, with or without incredible effort, making breakfast for ourselves and perhaps our family, getting everyone dressed and out the door to work and school, dinner, bedtime. Rinse, repeat.

We need to stop the facades and be honest and real with each other.

If we never make it past the small talk to really open up to a friend or neighbor about our depression, or our anxiety or our eating disorder or whatever it is that we’ve hid for so long because we were scared of being judged, then how would our friend ever be able to love us as who we are? It's hard to accept what we don’t know. What we don’t understand. What we don’t see.

I’ll give you an example.

One night, in early 2006, in the midst of the severe depression and anxiety I had been wrestling with since being diagnosed, I went out to dinner with my two best friends to celebrate a birthday. I don’t know how I managed to get myself up and out of bed, but it probably had something to do with the fact that we were going to my favorite restaurant {Sweetwater Tavern} and I must have been craving the salmon salad. Plus, my friend’s birthday.

K picked me up and we met M there. We had a nice meal, and the check arrived at the table to be paid at our convenience because they’re very efficient at Sweetwater. I can’t remember who paid the tab, but someone did or we split it, but it was settled, and we were just lingering there at the table, M and K finishing their drinks before leaving when it happened.

I had an anxiety attack. The normal buzz of the crowded restaurant which never used to bother me before suddenly made me want to run for the door. A wave of panic rushed up my legs and settled in my gut. I needed to get out of there.

“Are we done? Can we just go already?” I blurted out, not knowing what else to say, and not realizing how it would affect my friends.

They both stared at me for a second.

“What’s wrong with you?” M asked, frustration and confusion apparent in her tone. K shot me a look that seemed to ask, “Are you okay?” They had no idea.

I managed to squeak out something about being ready to go, apologizing for being so pushy, and they bought it. But I never did have the hard conversation. I don't blame them one bit for their reactions. They didn't know. It took me another year before I really tried to explain to them what was happening to me. What it felt like on the inside. I tried to explain the invisible.

I had plenty of reservations about revealing to the world that I’ve been living with bipolar disorder since my first manic break in December of 2005. You could say I was terrified. But it was also clear as day to me that the benefits of sharing my story were what made me feel good about my decision. Sure, there were the negatives. I may face discrimination in the future from people who don’t understand my condition or from those who may be afraid because of what they’ve seen in the media. But by standing up and speaking out in a positive, unique way, I hope to minimize any form of intolerance I may encounter in the future.

Which is why I am so proud of what is happening with This Is My Brave. We’ve come so far in seven short months. This week we announced our cast, and next week we’ll begin introducing them to the world so that you can see just how wonderful they are and why you need to come to the show in May. They’ll be up on stage, sharing a piece of their heart with you so that you can better understand their journey. Because at first glance, you’d never say to yourself, “Oh, she definitely spent a year battling agoraphobia, it’s obvious” or “You can tell he was arrested during a manic episode.”

These are invisible illnesses which we’re making visible because it’s time we shine a spotlight on mental illness. By bringing it into the light we illuminate the hope that lies in recovery so that no one who has been touched by a mental health issue has to feel alone.

I experienced both a postpartum mood disorder (postpartum psychosis) and a perinatal psychiatric issue (a manic episode which led to psychosis) very early on in my second pregnancy. I had been diagnosed with Bipolar Disorder two years before my husband and I decided to start a family, and yet I found limited support and information in my quest to have as healthy a pregnancy and postpartum experience as I could. When I think back to that time in my life, I strongly believe that if I had received better screening - particularly after my first pregnancy - much of the trauma and heartache of what I went through could have been avoided.

Before I experienced mental illness on a personal level, my ignorance of the various forms of psychiatric conditions caused me to judge people whose stories were covered in the media. I remember watching news coverage of the Andrea Yates trial thinking HOW COULD THAT HAPPEN? And then it happened to me seven years later. Thank God my outcome was drastically different.

Just this week a pregnant mother and her three children were rescued in Daytona Beach, after she drove the family minivan into the ocean. A family member had called police hours earlier to express concern over her strange behavior, including talk of demons. On the 911 tapes, you can hear the sister request a well-being check because "she's like having psychosis or something."

This woman literally saved her sister's life, the lives of those three children and the life of her sister's unborn baby with that call for help.

They were lucky to have avoided an outcome similar to that of the Andrea Yates case. Simply because someone close to the person who was suffering took action.

Now it's our turn to take action. There is an urgent need for changes in the way we screen women during pregnancy and postpartum in order to stop incidents like these from ever occurring in the first place.

Maybe this woman's sister recognized what her family member was going through because of the increase of more open dialogue about women's mental health issues. I can feel the wave of mental health awareness gaining momentum and hope that very soon there will be less ignorance out there and more acceptance. Because together we can make a difference.

Which is why I support this important White House petition to create mandatory universal mental health screening for pregnant and postpartum women. Did you know that suicide is the leading cause of death for women during the first year after childbirth? Or that 1 in 7 women will experience a mood or anxiety disorder during pregnancy or postpartum, yet nearly 50% remain untreated?

We need change. We need to screen every mother, every time to prevent and treat perinatal mental illness.

Recovery is possible - I am a perfect example of this. But wouldn't it be incredible if in the future we could catch cases like mine before they escalate? Before they lead to suffering and even death? No woman should have to suffer in silence because she's afraid to admit what she's thinking or feeling. We need to provide her with the chance to find recovery early. We need to recognize the signs and symptoms and take action.

Please take a moment to sign the petition: Every Mother, Every Time. Creating a WhiteHouse.gov account takes only a minute and there are simple tools to share the petition on Facebook and Twitter once you have submitted your signature.

This movement will save lives. We need 100,000 signatures to get the attention of the Obama Administration. Let's come together to make our voices heard on this critically important issue.

Jennifer Marshall

Jennifer Marshall is a mental wellness speaker and the Co-Founder/Executive Director of This Is My Brave, Inc., the leading platform for individuals to share their story of overcoming mental illness through creative expression.